David Cameron’s speech on NHS reform at 11:30am yesterday morning did little more than redistribute well-worn Conservative soundbytes like “evolution, not revolution” and reaffirm the government’s robust commitment to pushing on with the process of change.

But will the prime minister show the same support to his beleaguered health secretary Andrew Lansley?

During the speech, Mr Lansley was nowhere to be seen. Despite the listening, pauses and advisers, Cameron had still taken it upon himself to, as BBC 4 political correspondent Norman Smith put it, “make the case for change all over again” - despite it being Lansley’s change he is having to defend.

The health secretary was only mentioned on one occasion during the speech, in passing, towards the end.

And with “substantive changes” again promised by Cameron as he seeks to calm opposition from all sides, the reforms appear to be moving further and further away from Lansley’s original vision.

It isn’t surprising, then, that the 5/1 odds on Lansley being the next Cabinet member to leave office put him second only to Chris Huhne, after allegations over the weekend that the energy secretary had asked other people to take the blame for speeding offences on his behalf.

But with Ladbrokes making Huhne odds on NOT to leave before 1 June, when the Steve Field-led Future Forum is due to report back to Cameron, Andrew Lansley must be cutting a lonely figure just now - and will be hoping he is still hanging on by the time the government announces its reform Plan B.

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